Abdomen 06: Posterior Lymphatic Wall And GI Lymphatics Flashcards
False pelvis
The pelvic region in the abdomen cavity (above the sacrum)
Iliolumbar ligament
A ligament running from L4/5 to the ilium of the pelvis
Iliac crest
The superior edge of the pelvis, on both right and left side
Where does the lumbar plexus form?
On the psoas major
What is the origin of the psoas major?
Bodies of T12-L5 and intervertebral disks
What is the insertion of the psoas major?
Femur
What innervates the psoas major
Ventral rami of L1-L3
What is the action of the psoas major?
Flexes thigh
What is the origin of the psoas minor?
Lateral bodies of T12 and L1
What is the insertion of the psoas minor?
Pelvic bone
What nerve innervates the psoas minor?
Ventral ramus of L1
What is the action of the psoas minor?
Flexes trunk
What is the origin of the Iliacus?
Upper iliac fossa, upper-lateral sacrum, anterior sacro-iliac and sacro-lumbar ligaments
What is the insertion of the Iliacus?
Femur
What nerves innervate the iliacus?
Femoral nerves of L2-L4
What is the action of the iliacus?
Flexes thigh
What is the origin of the quadratus lumborum?
Iliac crest and the ilio-lumbar ligament
What is the insertion of the quadratus lumborum?
Transverse processes of L1-L4 and 12th rib
What nerves innervate the quadratus lumborus?
Ventral ramus of T12-L4
What is the action of the quadratus lumborum?
Extends and laterally flexes vertebral column
Psoas sign
Using the flexion or extension of the thigh against resistance to cause pain if irritated by any of the associated organs
What organs can be responsible for psoas sign?
Kidneys, ureters, retrocecal appendix of the right side
Kidney
Retroperitoneal organs that filter blood and extract urine and other wastes
Renal hilum
A slit like opening to the kidney
Renal sinus
A fat-filled space inside the kidney
Renal cortex
The outer layer of the kidney
Renal medulla
The inner layer of the kidney
Renal columns
Extensions of the renal cortex deep into the kidney
Renal pyramids
Sections of the kidney that consist of medulla
Minor Calyx
Connects to a renal papillus; part of the tract of urine outflow
Renal papilla
Tips of the renal pyramids
Major calynx
Where multiple minor calynx ducts meet and fuse
Renal pelvis
Where urine is gathered in the kidney before it is sent to the ureter
What is the pathway of urine?
Papilla -> Minor Calyx -> major calyx -> renal pelvis -> ureter -> bladder
What is the general pattern of renal arteries and veins?
Arteries usually behind veins
What organs are associated with the right kidney?
Right suprarenal gland, liver, descending duodenum, right colic flexure, small intestine
What organs are associated with the left kidney?
Left suprarenal gland, stomach, spleen, pancreas, left colic flexure, descending colon, jejunum
From medial to lateral, what muscles are associated with the kidneys posteriorally?
Psoas major, quadratus lumborum, transversus abdominus
Gerota’s fascia
Renal fascia that is fused into a bag and opens medially around the kidneys; continuous around ureters and vessels inferiorally
Perinephric fat
Fat inside the renal fascia that immediately surrounds the kidneys
Paranephric fat
Fat that lies outside the renal fascia
What is the visceral innervation of the kidneys?
Least splanchnic, which arises from T12-L2
Ureters
Retroperitoneal muscular tubes that carry urine from the renal pelvis to the bladder
What are the 3 constriction joints of the ureters?
Uretopelvic junction, pelvic inlet, entrance to bladder
What are the arteries to the ureters?
Branches from: Renal arteries Testicular arteries Common iliac artery Internal iliac artery
What is the visceral innervation of the ureters?
T11-L2
What is the referred pain region of the kidneys and ureters?
Groins/flanks, pubic region, and genitals
Suprarenal glands
Endocrine lands sitting on the superior poles of the kidneys, located on the perinephric fat
What is the right suprarenal gland related to?
Liver, IVC, diaphragm
What is the left suprarenal gland related to?
Stomach, pancreas, spleen, diaphragm
What are the arteries that supply the suprarenal glands?
Superior artery from the inferior phrenic artery
Middle artery from the aorta
Inferior artery from the renal arteries
Where do the left and right suprarenal vein drain to?
Left: left renal vein
Right: IVC directly
Suprarenal cortex
Outer layer that secretes mineralocorticoids, glucocorticoids, and sex hormones
Suprarenal medulla
Main source of adrenaline and noradrenaline
What are the three zones of the suprarenal cortex?
Zona glomerulosa -> zona fasciculata -> zona reticulata
Where does the subcostal nerve branch off of?
T12
Where does the ilioinguinal nerve branch off of?
L1
Where does the iliohypogastric nerve branch off of?
L1
Where does the genitofemoral nerve branch off of?
L1/L2
Where does the lateral femoral cutaneous nerve branch off of?
L2/L3
Where does the obturator nerve branch off of?
L2-4
Where does the femoral nerve branch off of?
L2-L4
Where does the lumbosacral trunk branch off of?
L4/L5
Where does lymph from before the diaphragm drain to?
Posterior abdominal lymph nodes
What are the layers surrounding the kidneys, from superficial to deep?
Paranephric fat -> Renal fascia -> Perinephric fat
What are the layers of smooth muscle in the wall of the bladder?
1) Outer circular
2) Inner longitudinal
It’s the opposite of the gut tube
Where is the suprarenal cortex derived from?
Neural crest cells
What is the blow of flood through the suprarenal cortex?
Suprarenal arteries -> capsule -> cortex -> subcapsular plexus -> long cortical artery -> medullary veins -> suprarenal veins -> IVC
